Zhou Z J, Xie J L, Wei P, Zhou X G
Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Bing Li Xue Za Zhi. 2017 Sep 8;46(9):618-622. doi: 10.3760/cma.j.issn.0529-5807.2017.09.006.
To investigate the pathological types and prognostic factors of primary lymphoma of breast (PLB). The clinical pathological data of 115 cases of PLB during October 2006 to October 2016 were retrospectively analyzed, and the basic clinical and pathological data, pathology types and the immunohistochemical slides by EliVision two-step method for staining were summarized. Almost all the patients were women (113/115), and the median age was 52 years old (range: 27 to 81 years old). The main symptom was painless progressive mass in breast. Ten cases (8.7%) showed B symptoms. The masses were mainly confined to the unilateral breast (80.9%, 93/115), of which 22 cases showed axillary lymph nodes enlargement in the same side. The average diameter of masses was 3.0 cm (range from 0.5 to 9.0 cm). There is no differences between the sides (left or right). Pathologically, 106 cases (92.2%) were mature non-Hodgkin's B-cell lymphomas, of which there were mainly diffuse large B cell lymphoma (DLBCL, 64.3%) and mucosa associated lymphoid tissue (MALT) extranodal marginal lymphoma (17.4%). Five cases (4.4%) were mature T/NK cell lymphomas, including extranodal nasal NK/T cell lymphoma (1.7%), peripheral T-cell lymphoma non-specific type (0.9%), subcutaneous panniculitis-like T cells lymphoma (0.9%) and undivided (0.9%). Four cases were lymphoblastic lymphoma. According to Ann Arbor staging criteria, 93 cases were stage ⅠE (6 cases were stage ⅠEB), 22 cases were stage ⅡE (4 cases were stage ⅡEB). Ninety-two cases were followed 1 to 122 months (median: 36 months). The five-year overall survival rate was 85.3%, and 13 patients dead. B symptom was one of the factors that affect the prognosis (<0.05), but the pathological type has no relationship with the prognosis (>0.05). PLB is relatively rare, the main clinical manifestation is painless mass, which is difficult to distinguish with breast carcinoma. The most common type is DLBCL, followed by MALT lymphoma, while T cell lymphoma is rarely seen. PLB is early stage tumor with good prognosis, while patients with B symptom turn out to suffer worse prognosis.
探讨原发性乳腺淋巴瘤(PLB)的病理类型及预后因素。回顾性分析2006年10月至2016年10月期间115例PLB患者的临床病理资料,总结其基本临床病理数据、病理类型及采用EliVision两步法染色的免疫组化切片情况。几乎所有患者为女性(113/115),中位年龄为52岁(范围:27至81岁)。主要症状为乳腺无痛性进行性肿块。10例(8.7%)出现B症状。肿块主要局限于单侧乳腺(80.9%,93/115),其中22例同侧腋窝淋巴结肿大。肿块平均直径为3.0 cm(范围0.5至9.0 cm)。两侧(左侧或右侧)无差异。病理上,106例(92.2%)为成熟型非霍奇金B细胞淋巴瘤,其中主要为弥漫性大B细胞淋巴瘤(DLBCL,64.3%)和黏膜相关淋巴组织(MALT)结外边缘区淋巴瘤(17.4%)。5例(4.4%)为成熟型T/NK细胞淋巴瘤,包括结外鼻型NK/T细胞淋巴瘤(1.7%)、外周T细胞淋巴瘤非特指型(0.9%)、皮下脂膜炎样T细胞淋巴瘤(0.9%)及未分类(0.9%)。4例为淋巴母细胞淋巴瘤。根据Ann Arbor分期标准,93例为ⅠE期(6例为ⅠEB期),22例为ⅡE期(4例为ⅡEB期)。92例患者随访1至122个月(中位:36个月)。5年总生存率为85.3%,13例患者死亡。B症状是影响预后的因素之一(<0.05),但病理类型与预后无关(>0.05)。PLB相对少见,主要临床表现为无痛性肿块,难以与乳腺癌鉴别。最常见类型为DLBCL,其次为MALT淋巴瘤,而T细胞淋巴瘤少见。PLB为早期肿瘤,预后良好,而有B症状的患者预后较差。